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Most Malaysians would have already heard about the plight of the medical staff at Kuala Krai Hospital by now. The text has gone viral through Facebook and Whatsapp for the past 24 hours. Even the mainstream media got a hold of the story.

While most Malaysians are at home with their loved ones, either celebrating Christmas or just enjoying the public holidays, some Malaysians will be spending the holidays drenched in flood water. Rescue workers and medical staff are on high alert at this moment to react to this disaster. Leave for medical staff in the Eastern states have been frozen. I wish my colleagues in the affected states all the best.."Kami sedia membantu"

I have taken the initiative to compile the details of the various NGOs which will be providing aid to Malaysians affected by the floods. I would love to join the relief efforts, but due to some family matters I am unable to do so. At least two NGOs are gathering medical volunteers to aid victims in the affected area and will be leaving for the respective locations tomorrow (25th December 2014). For those interested, do take the time to join them.

HO...HO...HO....looks like Santa Clause dropped by a week earlier this year!

The HO I am referring to is H-dot-O...Housemen. Last week might as well have been Housemen Week. A time when everyone in the medical field take some time to appreciate the contributions of Housemen. Without them the whole hospital would cease to function.

Who will trace lab results in the morning before rounds? Who will draw blood of in ward patients in the morning? Who will clerk new admissions to the ward? Who will run to the radiology department to get an early appointment for CT scan? Who would be called up at 3 am in the morning to set a new IV access?

Who else will do ALL these without housemen?!

Well, in another dimension called district hospital and even some clinics, MOs have to do it all by themselves. Its mind boggling how 3 to 4 MOs can manage a hospital all by themselves. Review patients in the ward, attend to new cases in the emergency room and then see patients in the outpatient department. To all MOs in district hospitals out there....I salute you!

All these 'hoo-haa' about housemen started with a letter from a disgruntled parent Disgusted Malaysian.

Two main issues were brought up in this letter to The Star;
1. Long working hours without rest.
2. Maltreatment by senior doctors.

Last week I wrote a piece on the case of a hospital being sued by a student for failing to inform her of the risk of taking antibiotics. That post garnered more than 10,000 hits in a day. A few days later, a private hospital was accused of causing the death of a teenager by negligence. A lot of doctors felt like doctors were being bashed left and right. It was a tense week.

Then out of the blue, a colleague from the Malaysian Primary Care Network (MCPN) stumbled upon a blog by a certain Professor Doctor XXX practicing alternative medicine.The content of the blog defied ALL medical knowledge.

I personally think that he was a THREAT to public health and safety. He has since taken down TWO ridiculous post from his blogspot but his company's site is still active. The Q&A section of the company's site has been bombarded with questions about his legitimacy since the revelation in MPCN....to the guys attacking his site; please don't be so harsh and use foul language.

I tried to check the company's details with the Traditional and Complementary Medicine website but I can't find a proper link. A search at e-pengamal TCM online was futile as well.

An email was sent to the department to get further clarification as well but it has been three days (and counting) and still no reply. I also ran a search to see whether their products have been approved by the National Pharmaceutical Bureau but NOPE! No such approval was given to any of their products.

This lady had hypoglycemia. What she does next will make you speechless!

Still speechless?

Yup, all she did was drink a glass of magic EFGHI drink and she miraculously recovered from HYPOglycemia! A glass of teh tarik would do the same, but the reading would be 15++ mmol/l with a sprinkle of ketones secukup rasa. (Diabetic Ketoacidosis)

A few days back, a screen capture of a surgeon bashing an MO from primary care on Facebook went viral. It even got the attention of the Health D-G. I won't paste the screen capture here as I am sure most of my fellow readers have already read it on Facebook or Whatsapp. Basically, it goes something like this (in no particular order);

"What la, KK MOs. Which hole did they come from?""It is worse teaching MOs from KK than HOs""These MOs are like cows"

But is this something new? Specialist (and even MOs) from each discipline will rubbish the other disciplines. Surgeons will say physicians only know how to order tests and gets nothing done, while the physicians will say surgeons only know how to potong. From my personal observation the top of the hierarchy always goes to the surgical based discipline while the bottom most are the doctors from primary care. Even the public has this mindset, doctors working in the hospitals are ALWAYS better than those in Klinik Kesihatan and primary care.

Housemanship. The mere thought of it sends chills down (almost) every medical student's spine. It's often referred as hamba orang or other people's slave. In the hierarchy of the hospital housemen are regarded as the lowest of the lowest....that's what people say la.....including me. Has any one ever wondered why I was never HOfrust? Why lompat terus jadi MOfrust?

A friend of mine wanted to share her thoughts on working at Klinik Kesihatan (Local Clinic) but didn't want to start a blog. Some members of the medical fraternity may consider working at KK as goyang kaki but there is so much to that. So, with her permission here are Dr Mei Mei's (not her real name) thoughts.

It is almost two years...that i committed myself to an 'area' i prefer...yes..primary health care @ health clinic @ 'low class clinic' to some people...i wouldn't say i regret coming here...but definitely things could be improved...if more people realized or are aware of how things are done..in the health clinics... i would use my 'little' clinic as an example...as it wouldn't be fair for me to comment on other clinics...

First of all...Clinic is not a 'Supermarket'...for you to enter the doctor's room like you are doing window shopping..and keep asking the doctor how come your number has not been called...or just barge in as you like and requested for medication without even registering...or pulled the chair in the doctor's room and start chit chatting with them over non-medical issues...or keep telling the doctor 'i should be seen first because I am working (but later requested for MC)/ my daughter should be seen first because she has school (when you daughter could have come in the afternoon for the medical check up) when there are more ailing people or elderly who actually waited patiently...or not telling doctors your symptoms but requesting for this medication...that medication... because you assumed you have already known your diagnosis before seeking treatment... (I was surprised how come over the counter medication were not purchased instead)...

Budget 2015 is just a few hours away. Last year's budget wasn't that great to begin with and I have a feeling that next year's wouldn't be great as well. Despite efforts by the media to paint a rosy picture of Malaysia having a bright economic future, the rakyat maerhan (am I spelling it correctly?) are not feeling its benefits. Well, the stock market has been excellent and gold prices were at it's best (read as cheap to collect). Unfortunately, prices of everything went up but salaries remained the same. Hey, even the MPs are having a hard time; they have to tie their neck stomach (ikat perut)....so much for the RM 2,500 sebulan pun cukup!

It is only natural then that the cost of healthcare will go up with the GST coming in (NOT ALL medical equipment are zero-rated) and a few more rounds of subsidy rationalizations (you still need fuel for EVERYTHING!). When private healthcare becomes too expensive, where do the rakyat marhaen go to? Government health centers of course! I am expecting more crowd in government hospitals and clinics in the months to come. I have no complaints; the facilities are for ALL MALAYSIANS. But I have a few tips for the public to UTILIZE these services properly. Utilize NOT abuse!

EMERGENCY DEPARTMENT1. Ambulance:
i. The ambulance service is for EMERGENCY cases only. If you can walk and talk, it is better to go to the hospital yourself. Being too tired because of a fever is NOT an indication.

ii. When calling for an ambulance, please call 999 call center. DO NOT call for one through a direct line or stop one at the side of the road. That ambulance might be heading somewhere to retrieve a dying patient.

iii. Ambulances are for those that are alive. NOT for the deceased. Please do not complain to the MARVELOUS Harian Mxxxxx when the paramedics have ascertained a person is dead and call the police instead. They are doing their job to SAVE LIVES, NOT to bring back the dead.

iv. Please provide the exact location and circumstances of the event. They are not being 'busy body' and trying to waste your time. The paramedics need to prepare themselves with the right equipment. Saying 'depan tiang elektrik yang ke sepuluh' won't help too.

"I should have read up on how to read a CTG on Google before agreeing to the doctor's decision"

A disgruntled mother

Cardiotocography: A graphical representation of the fetal heart rate and uterine contractions. It is used to determine the well being of the fetus.

This is roughly what was written by a lady on her blog relating her displeasure regarding her experience delivering at a private hospital. She bashed the doctor pretty nicely. She clearly mentioned the doctor's name and the hospital. It appeared like she was all out to shame the doctor and the hospital. The comments that were made by some members of the public were mean and viscous as well. I am not able to provide a link to the website as it has been removed from the net since 20th September 2014. Instead, a special blog was set up as a statement of apology by the blogger.

Now, that IS something. A specific web address, for ONE specific purpose...looks like someone received a note from a lawyer. I find this interesting as there has been a never ending doctor bashing on social media lately such as the rather kurang ajar lady complaining about a doctor at ED taking a rest in the wee hours of the morning and not see her NON-EMERGENCY case quickly. I give the team at KJMC (lawyers, management and Dr Fatima Najla) a thumbs up for upholding their rights. Dr Fatima Najla deserves a pat on the back for not proceeding any further and sue the blogger. I don't think its worth it, the blogger should be given a chance as well.

That was a term given by a Dr Helmi Razali, a Malaysian doctor working in UK. While most medical doctors from the pre shift system era or 'ONCALL FROM HELL' era have said some nasty things about him such as referring him as a 'weakling' and kacang lupakan kulit. He DID use some harsh language in his blog such as "...rasa macam nak hadiahkan sebijik pelempang dengan selipar Jepun" while referring to some old school-back-during-my-days doctors. But if you just take a deep breath, not be emotional...he does have a point. There is plenty of room for improvement. Not just plenty there is an ENORMOUS amount of room for improvement!

First off though, something needs to be done regarding the number of placements for medical students.Case in point the sudden addition of 100 more spots for medical students in public universities (The Star). The decision was magically made after a student complained to the press about not getting a place to study medicine. (refer to Supply and Demand)...but please I don't mean to be seditious here.

On 11th September 2014, the newspaper portal, Sinar Harian highlighted the plight of a 2 years old child with biliary atresia. The family is seeking funds of RM 150,000 to get treatment in India, possibly to get a liver transplant.

"I pay my taxes promptly. Why should I pay RM 1 to see a doctor at a government clinic?! Healthcare should be free.""I paid taxes for this? Why should I have to wait so long? Such a big hospital and not enough staff to attend to my 37 degress Celcius fever? What a waste of tax payers money""Bonuses for government servants? Why waste tax payer's money on slow, lazy staff?!"
Its a common complain among Malaysians. I pay taxes, I should be treated like royalty! There is some truth to that. The rakyat should be treated like royalty. Rakyat di dahalukuan. But I am not here to talk on politics. If I say to much, I'll be charged with sedition (last week's word of the week). So let's stay clear of that for now.

Recently a pharmacist posted on Facebook about how she received a stack of mixtard, a type on insulin for diabetics, at her dispensary. Based on the picture, it looks like a year's worth of medications. She received the vials from a patient who has accumulated it over months but failed to comply to the treatments given. Unfortunately, the whole pile of mixtard were all expired.

A while back, a lady came to the clinic complaining of a skin lesion on her left ankle. She had a fall a week prior to the visit and claimed to have had a fracture actually she said...

"Retak ke patah, saya pun tak tahu doktor tu cakap macam mana"
I have no idea what that means either. Retak = crack. Patah = break. Break or crack, still fracture la kan? Anyway, a cast was put in place by the doctor and she IMMEDIATELY took it off and went to a Sinseh. The cast was removed and a concoction of herbs was wrapped around the injured area.

Any of this tulang can patah, retak or whatever you call it!

"If I had used the cast, I would not be able to walk at all" said the lady. I could see that she was walking but she was clearly limping. Her ankle was still swollen and I saw some resolving bruises around the ankle. The skin was bad too. It was dry and excoriated. Skin were peeling off. It is most likely due to contact dermatitis with the herbs.

What is happening in Malaysia today? Too many bright students I suppose. Its good that the young lady has a passion to study medicine but does she know what she is getting into? Does she know what it takes to be a doctor? Its not enough to just have good grades! There is so much more to it! I really hope this meme does not reflect her reason for wanting to take up medicine (linked to my previous post on SPM Top Scorers).

Kool Fever can cause cerebral palsy if used often! Please don't put it on the forehead but instead apply it at the back of the neck for 'thermostat effect'. Please, this is not a hoax. Sharing is caring!

According to Medscape, manifests in early childhood and is characterized by qualitative abnormalities in social interaction, markedly aberrant communication skills, and restricted repetitive behaviors, interests, and activities.

For the past decade autism has been widely linked to VACCINATIONS. Thanks to the graduates of University of Facebook, University of Google and most importantly a not so bright scientist. the link between vaccination and autism is so great that some parents refuse vaccines even though they smoke in front of their kids, feed them junk food and let them play with mercun bola! Never mind that the kids can get chronic lung disease, predisposition to obesity and losing a limb.

I am NOT a credited scientist or specialist. I have not done any studies yet. But from my short term observation for the past TWO years, I have seen some link between CHRONIC, UNRESTRICTED use of smartphones and autism....well, not really autism but perhaps pseudo-autism (please correct me if I am wrong...with facts).

Neee-noooo, neee-nooooo....there goes a siren of controversy! I can already hear some people say;

Esok nak Raya! While others are enjoying themselves at their kampung halaman or just enjoying the long holidays jalan jalan cari makan, there are some who won't be Raya-ingwith their families this year. Just like Citibank, the hospital never sleeps.

This cute video has been making its rounds on social media for a few weeks now. It was made by the nice people at the orthopaedics department of Hospital Sultan Ahmad Shah, Temerloh. Its a tribute to all the staff that will be working through out the Raya holidays period.

Thursday night, 17th July 2014. It was 11.50 p.m. I don't usually log in to Facebook before bed but I accidentally pressed the Facebook app on my phone that night. to my surprise on the top of my news feed was:

"Tgk cctv news channel 509...flight MAS 777 crashed kt border russian-ukraine..."
Is it another hoax or is it real news, I thought to myself. This friend of mine is not the type that post rubbish updates on Facebook. As I scrolled down, links from major news agencies popped up. Unfortunately, it turned out to be true.

As a Malaysian I feel sad. I feel a great loss. Please don't politicize this. Please don't make it into a religious and racial issue. Please respect the families who lost their loved ones & please don't share fake updates...there's already a picture of a MAS plane when it looks like a photoshopped scene from Lost.

Despite common belief that I wear my mask to work all the time, I DON'T. I am just a simple doctor at a small clinic. I have facial hair like Hugh Jackman's Wolverine. Just imagine me as Wolverine with all the muscles but instead of six packs, I just have ONE big pack and a few spare tyres.

Yep, that's how I look like!

If I were to wear my mask to work, I would totally understand why patients refuse to trust my words as I would look like a joke. But why don't they believe me? Believe me and my colleagues? Why so like that one?!

I encountered TWO scenarios these past two weeks that left my mind boggling....just like a bad episode of SENARIOOOOOOO.

A few weeks back, I read a Facebook post about how a houseman (HO) talked a patient out of depression. I can't verify the authenticity of the post but it is inspirational. The whole post is rather long and in Bahasa Malaysia. Click on the link to read the post (but please don't click on MyMetro).

I tried translating it into English but it doesn't sound as nice. It doesn't do justice to the original author. If you can understand Bahasa Malaysia, do read the whole post.

This was the letter to the editor on 12th June 2014 about a senior citizen being given a runaround at Serdang Hospital. Initially I wanted to just let the PR people at Serdang Hospital deal with it but there wasn't any response on 13th June. So I came out with my own reply in today's The Star (14th June 2014). My original title was Sharing the resposibility.

Referring to the letter by Shah D. from Puchong entitled Senior given runaround at hospital, it
is most unfortunate that he had to endure this. Fortunately for him, Serdang
Hospital has an integrated computerized patient database otherwise the
experience is worse. I do agree that some policies and systems in the hospital
are not patient friendly. However please bear in mind that the system is in
place to manage thousands of patients visiting the hospital daily.

Specialist clinics in hospitals are not meant for walk in
patients. Specialist hospitals like Serdang Hospital are referral centers. If a
patient is stable and the medications are available at local clinics, patient’s
care will be transferred to be managed at a local health clinic (Klinik
Kesihatan). Even in the current state, appointments for the first visit can
take up to 3 months due to the patient load. Who doesn’t want to be seen at the
specialist clinic for a mere RM 5 per visit? Even with the low fee, there are
some well to do government officers who create a big fuss when being charged
RM5.

It wouldn’t be fair to put the blame on the hospital. Two
years of defaulting treatment is a long time. You just can’t decide to come to
the hospital and be seen straight away. That wouldn’t be fair to the other
patients who waited three months for their appointments, stick to their
appointments and follow the doctor’s advice on health management. I am sure
there might be some reasons for defaulting the appointments. But what can be
more important than your health? If the medical staff are prepared to help with
the limited resources, why not help
yourself?

I do agree that more can be done to make hospitals patient friendly, especially towards to the senior citizens (regardless pensioner or not) and the disabled. But health care is a shared responsibility. You can't bertepuk sebelah tangan.

While others are fast asleep with their loved ones at home, cuddling each other lovingly or hanging out with friends after a late night movie, people called 'doctors' are stuck in the hospital hard at work trying to save lives. Life is a bit more difficult for doctors in remote, understaffed and under equipped district hospitals. No specialists around to ask for help and a lot of times when trying to refer to a tertiary hospital some cocky MO will sound:

"Aiyya, that one also want to send ah? So stupid cannot manage there?"

The sad part is, while you are busy saving lives and giving everything you have, no one is there when its your life that needs to be saved.

It was a sad day when news broke out about a medical officer who died after completing his on call. No one knew exactly what happened as he was alone at the time. He was only found after others went out to look for him. Maybe he was overly exhausted or may have had some underlying medical condition. The patients that survived that night at Hospital Alor Gajah might have been saved by this particular doctor.

Despite the somber mood of the Malaysian medical fraternity after hearing the sad news, some rubbish journalist published something uncalled for in the mainstream media. I am not sure if it was in their print copy though (I do not enjoy reading both of these newspaper anyways), but it was on their online portal. NST.com.my most probably noted the intense anger at the journalist and deleted the link (link unavailable since 12th June 1215am) but myMetro remains a nonsense newspaper.

"Naked doctor found dead in toilet" was the HEADLINE.

Is it so significant to highlight that the doctor was found naked in the toilet? Is anyone supposed to be fully dressed in the toilet?

Sigh.....another day, another potential heart attack as I explore Facebook. Another fake public service announcement by some unknown, non medical source. Compared to my previous post on the relationship between not bathing for the first 3 days of menses and postpartum mortality, this THING about first response to stroke is BLOODY PREPOSTEROUS!!

Once upon a time, on one fine day, I received a group text from one of my non-medical Whatsapp group. My beautiful day was ruined. The contents broke my heart....

Attention to all ladies, do not bathe and wash your head (hair) during the first three days of period, its dangerous! PROVEN BY SCIENCE 80% of women die during labour due to uterine swelling.

I felt cheated. I was not an excellent student in medical school. But I MUST HAVE slept throughout ALL my O&G lectures to have missed THIS fact! My lecturers and specialists lied to me. Why did they ask me to waste time going through other risks factors of post partum haemorrhage such as grand multi para (banyak kali mengandung dan bersalin)? NO ONE taught me to get THE MOST important history of all.

" Awak ada mandi tak ketika 3 hari pertama datang haid?" (Did you bathe during the first three days of your menses?)

So FRUST la like this!

But seriously, I feel more 'frust' when people actually share this kind of rubbish. I have no idea how they can formulate a study for this. Cohort? Cross sectional? How will they be able to study the pathophysiology?

Here lies the beauty of being a graduate of The Medical School of Whatsapp. You can write all sort of rubbish and put a nice ending to it to make others share like:

"Share this if you love your lady friends"

"Share this to 1000 friends and you will CURE cancer"

This rampant spread of rubbish and nonsense on Whatsapp can get quite irritating for health care workers. We have to explain and counter all these rubbish in the group itself so that it won't get out of hand. But when there are more than 10 individuals in the group, there will always be one who will say'

In a country as hot and humid as Malaysia, imagine if ALL the ladies with 3 days of menses don't bathe.

Bau harum semerbak (smells fresh!)

Anyways, if you want to share please verify the contents first. Don't la just mention Prof. Dato' Dr. Haji MOfrust yang cakap. If its medical related mention which university and his specialty. Maybe the journal if nak lagi power.

3............2.................1......................Fight! Its just like watching someone play Mortal Kombat.

One one corner is a Dr. (I think) V. S. from Mentakab, Pahang and in another corner is the honorable President of MMA, Dr. N. K. S. Tharmaseelan. Nay versus Aye. What does MOfrust think about the current HOship training?

When I first read the title, my knee jerk response was "WHAT absurdity is THIS? Marah kan nyamuk, kelambu di bakar." Is it really the doctor's fault?

Lets look at this scenario:

A patient with a severe back pain due to paravertebral muscle spasm went to a private hospital. On assessment by the MEDICAL OFFICER there is no neurological deficit (no numbness or weaknesses of the limbs) but pain score is 8/10. If the patient goes to a very busy government hospital with limited facilities and staff (and don't forget to pay RM 1!), all he will get is an intramuscular injection of analgesia (commonly diclofenac sodium) maybe do a lumbosacral x ray, less than an hour of observation, then discharge. And maybe an MC.

Someone shared this internal memo on Facebook recently. Its quite fresh; dated 23rd April 2014. According to the post, it was a particularly busy day with only limited staff manning the pharmacy counter. There was already a long line of patients waiting for their medications. This so called VIP came to the counter and demanded that the pharmacist attend to him first instead of giving him a number. Basically he was potong line. The pharmacist didn't bother with the request and gave him a number instead. The next day, the pharmacist gets a letter demanding his resignation because he did not fulfill the VIP's wishes.

Recently, I have just been made aware of a nonsense practice by a local pharmacy. The pharmacy sells some kind of "magical" water to unsuspecting individuals hoping for some "magical cure" for diabetes and hypertension. Some kind of rock is placed inside a container and patients are asked to drink 3 huge containers of the water. The worst part is, it cost roughly RM 90 PER SESSION.

Hi Mr MOfrust, I am Amy (not her real name). I am calling from Maybank Visa. We would like to send a package to you because you have been chosen as a lucky winner. The package contains a holiday card with attractive discounts and can be used at over 1000 merchants....bla...bla...bla. Now I would just like to verify your details.....bla.....bla....bla.

After a lengthy call...

RM599 will be charged to your credit card as service charge.

I have received numerous calls like this since I received my credit card years ago. I was fooled once, thinking it was a complementary card from the bank. Back then, I was financially illiterate. A perfect target for these scammers. Since then whenever I receive calls like this I will just say politely;

"Nanti saya check dengan Maybank ye"

Some will respond with

"We are actually not related to the bank but represent Visa. This is normal for all Visa customers"

Watching Budak Baru brings back all the memories of housemanship. Thank you to Simple_Prince for forwarding this video to me via my email (please do email me if you have any suggestions for this blog by filling in the form on the right).

The cinematography for this clip is amazing. The acting....OK la. The one thing that stand out most was how that guy performed CPR. You watched too much Ampang Medical! If you were my HO and I saw you doing that, sure KENA one! But that's just me nitpicking.

I was doing locum one day and saw a young lady. She came to the clinic with her father, She had sore throat and runny nose for the past 4 days. She had preceding fever which has since resolved. Clinical examination revealed nothing much. She was afebrile and her throat wasn't even injected. There was NO EVIDENCE OF INFECTION.

I told them that it might possibly be a resolving viral URTI. The father wasn't convinced.

Bagi la antibiotik doktor. Doktor lain bagi je....
It was still rather early and I still had some juice left. So I explained to them regarding antibiotics.

A common
chief complaint in Malaysia. The literal translation is “wind”. But getting a
diagnosis out of angin is totally
havoc. Everything can be angin from
dyspepsia, muscular pain, cardiac event, intestinal obstruction and fluid
overload.

Saya rasa angin la doctor.
Tengok urat urat saya ni timbul….buuuurppp (as he massages his veins). How
is it possible to get angin in veins
(urat)….is it AIR EMBOLISM? Why is he
not in respiratory

I think most, if not all medical graduates will understand this meme. Well, at least half of the graduates were persuaded by their parents either forcefully or in a subtle way. I don't have any statistics but there is a large portion of medical graduates who do not practice or have gone FRUST.

Today's tech savvy teenagers have got information at the tip of their fingers. Although some would rather play Pou or Candy Crash, at least they have some way of getting to know about a course before jumping into it.

During my time, in a galaxy far far away, the internet was just at its infancy. Does anyone still remember mIRC chat? That thing was whack! Teenagers then had their parents subscribe to the internet just to use mIRC (remember the modem? kukukuk....krrrkekekeekekekkkkkkkeeeeekkkk).

Tax. Its not something that people look forward to, especially with the rising costs of living. However, for the past 3 years, April is the time of year I can get some money back...from the Government (Lembaga Hasil Dalam Negeri)...LEGALLY.

I have heard a lot of grouses from my colleagues about taxes such as..

"Why do we pay taxes when the politicians keep on abusing it?""I don't want to pay taxes because I am not getting any benefit from it"
Well, maybe you are not eligible to pay income tax in the first place because according to LHDN (IRB), only ONE million out of the FOUR million individuals with files in LHDN are eligible to pay income tax.

Welcome to The University of Facebook where all your dreams can come true. You can be anything you want. We offer courses for free. All you need to do is just register online and update status and get as many likes and shares. Just look at all these testimonies from our alumni.Mr Stem:I used to be a school dropout but after graduating from University of Facebook, I now have a Degree in Medicine and Masters in Oncology. I can treat cancer with 10,000 likes and Triple Quadruple Stem Cell!

Recently, a patient made me realize I am a human being. She did not give me any thank you card or flowers. She didn't really do anything actually. It was just a feeling I had from seeing her predicament. I haven't felt this way in a long time. It is not exactly a great feeling but it is what makes humans HUMAN.

This lady had Diabetes Melitus Type 2. She was 14 weeks pregnant. She came to the clinic just to review her blood sugar profile. As I was doing a trans-abdominal ultrasound scan (TAS), I noted some deformity in the structure of the fetus. I scanned further and noted that there was an absent fetal heart.

Its the same piece of news, but the highlight is completely different. One is a reputable newspaper among businessmen, the other the most popular newspaper in Malaysia. Sadly, most of the patients I see in the clinic will carry the latter. That says a lot about the mindset.

Was this child actually given racun? But seriously, doctor prescribing POISON to a baby?....he should be charged of MURDER!!!! Come on la,takkan la orang nak kasi racun kot?Cukup cukup la merepek nye.

DENGUE. You will be a frog under a coconut shell (katak di bawah tempurung) if you haven't heard about it. Throw a stone randomly and it will hit at least one person who had Dengue. I had Dengue back in 2007 when I was still a student. It was bad. It was the worse fever I have ever experienced. I was aching everywhere. Thankfully it was just Dengue Fever.

Despite all the awareness campaign initiated by HE WHO SHALL NOT BE NAMED, there are still some misconceptions about Dengue.

1. Definition

Doktor, saya mau check darah. Takut kene Denggi
No fever. No myalgia and arthalgia. No headache. Not from Dengue endemic area.
In an ideal world, where resources are unlimited and chemical reagents are as cheap as a bottle of mineral water, I can kau tim and do it. Mo man tai! But the truth is, HE WHO SHALL NOT BE NAMED's resources are already stretched to its limit.
The reason why it is called Dengue FEVER or DEMAM Denggi is because...your typical presentation would be to have FEVER.
Dengue fever goes through 3 phases; febrile phase, critical phase and recovery phase.

Self explanatory diagram

Doctors will usually perform lab tests after Day 3 of fever. As per diagram, hematocrit and platelet levels will only derange after Day 3. That's it is important for patients to tell properly when they had the onset of fever instead of dah lama daaaaahhhh!!!! and ish, doktor ni mana la saya ingat!

Updated on 27/2/2014

Despite it being common practice to take FBC on Day 3 of fever, it IS recommended for FBC to be taken to get a baseline hematocrit and platelet. Hemoconcentration is when it is elevated more than 20% of the baseline value. Increase in hematocrit with concurrent rapid decrease in platelet IS A WARNING SIGN.

……being a doctor working in Malaysia, as a government
SERVANT is another thing all together. I have made 2 different drafts of this
post. I have tried my best not to be too critical of my PAYMASTER. Of course,
some people will go around saying;

It seems that our neighbour down south experiences the same problem as we do. Medical certificates or MC has been a duri dalam daging for doctors everywhere it seems. I haven't seen any assaults because of doctors refusing to give MCs....YET. But I have seen

Anyone could easily Google these terms and suddenly everyone can master anaemia....and EVERYTHING IS AWESOME!

Unlike building Lego blocks, everything is NOT awesome when it comes to real life hypovolaemic shock secondary to post partum haemorrhage. The main difference between between a houseman, medical officer and a specialist is EXPERIENCE.

It is getting harder to become a healthcare provider these days. First the consultoids, then the Facebook & Google consultants and the "semua ubat ni Yahudi laknat punya kerja" group, last but not least the 'over the top testimony' marketers (refer to Frust Lagi!). Now there are people throwing dirt on medical staff. Its hard to do work with passion and sincerity when you get comments like this:

The news in the last 2 weeks was abuzz with the New Automotive Policy. The announcement was highly anticipated by motor heads and economists since Budget 2014 (and 2013 Elections in view of BN's manifestos). I am not a an economist but I can consider myself as a car enthusiast. Paultan, if you are reading this I LOVE YOUR BLOG! If you can't tell the difference between a Myvi and a Viva, this post may not be significant. But if you can't tell the difference between a Perdana (Accordana) and an Accord, you may be forgiven.